NPI Code Detail JSON Logo

1457593790 NPI number — POSITIVE IMAGE PROSTHETICS & ORTHOTICS, INC

NPI Number: 1457593790
Health Care Provider/Practitioner: POSITIVE IMAGE PROSTHETICS & ORTHOTICS, INC

Information about “1457593790” NPI (POSITIVE IMAGE PROSTHETICS & ORTHOTICS, INC) exists in 1457593790 in HTML format HTML  |  1457593790 in plain Text format TXT  |  1457593790 in PDF (Portable Document Format) PDF  |  1457593790 in an XML format XML  formats.

NPI Number : 1457593790 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1457593790",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "POSITIVE IMAGE PROSTHETICS&ORTHOTICS,INC",
    "ParentOrgTIN": null,
    "OrgName": "POSITIVE IMAGE PROSTHETICS & ORTHOTICS, INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5202 WATERS AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAVANNAH",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "31404-6230",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "912-354-7500",
    "MailingAddressFaxNumber": "912-354-7887",
    "FirstLinePracticeLocationAddress": "300 NEW RIVER PKWY",
    "SecondLinePracticeLocationAddress": "BLDG 6 SUITE 12",
    "PracticeLocationAddressCityName": "HARDEEVILLE",
    "PracticeLocationAddressStateName": "SC",
    "PracticeLocationAddressPostalCode": "29927-4450",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "912-354-7500",
    "PracticeLocationAddressFaxNumber": "912-354-7887",
    "EnumerationDate": "04/01/2009",
    "LastUpdateDate": "04/01/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "PUCKETT",
    "AuthorizedOfficialFirstName": "DAVID",
    "AuthorizedOfficialMiddleName": "M",
    "AuthorizedOfficialTitle": "PRESIDENT/OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LPO/CPO",
    "AuthorizedOfficialTelephoneNumber": "912-354-7500",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "335E00000X",
        "TaxonomyName": "Prosthetic/Orthotic Supplier",
        "LicenseNumber": "000028",
        "LicenseNumberStateCode": "GA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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